Central Precocious Puberty in Boys; Diagnosis, Treatment and Follow-up: A Nation-Wide Study


Odabasi Gunes S., Sakar ., Muratoglu Sahin ., Karaguzel ., Ayça Cimbek ., Darendeliler F., ...More

61st Annual ESPE (ESPE 2023), The Hague, Netherlands, 21 - 23 September 2023, pp.361

  • Publication Type: Conference Paper / Summary Text
  • Doi Number: 10.1159/000533803
  • City: The Hague
  • Country: Netherlands
  • Page Numbers: pp.361
  • Akdeniz University Affiliated: Yes

Abstract

Objective: The aim of this study was to evaluate demographic characteristics; clinical, laboratory, imaging features; and response to treatment of boys who were followed up and treated with the diagnosis of central precocious puberty (CPP) in Turkiye.

Materials and Methods: The study was planned as a multicenter, retrospective study. Cases with a diagnosis of CPP, whose follow-up data were available were included. Patients with diagnosis of congenital adrenal hyperplasia (CAH), or with any other chronic systemic diseases were excluded.

Results: 297 cases were registered into the study and 266 cases were included. Mean age at diagnosis was 7.96±2.2 years and bone age was 9.53±2.53 years. 18.8% of the cases were obese, 30% was overweight and 3.7% had malnutrition. At admission, median Tanner stage was stage II, mean basal LH level was 1.33±1.59 mIU/ml, and total testosterone level was 5.78±71.82 ng/ml. The mean peak LH level of 201 subjects who underwent LH-RH stimulation test was 11.58±8.0 (5-74) mIU/ml. Peak LH/FSH ratio was lower in obese cases than in non-obese cases (P=0.005). Intracranial pathological findings were present in 37.6% of 247 patients who underwent cranial imaging. Duration of treatment was 32.17±23.53 months. Mean age at cessation of treatment was 10.55±2.55 years, and bone age was 12.78±0.99 years. 4.5% of the patients reached final height. It was determined that there was no change in the height-SDS, and there was an increase in weight-SDS and body mass index (BMI)-SDS of the patients during the treatment process (P<0.001). Total testosterone and DHEAS levels were higher in cases with intracranial pathology (P<0.05). Among the cases with and without intracranial pathology; height-SDS change throughout treatment and final height difference from target height were similar. Factors affecting the final height were height-SDS and predicted heightat the beginning of the treatment, paternal height-SDS and target height-SDS.

Conclusion: In this nation-wide study with a large number of male CPP patients, more than half of the cases were diagnosed as idiopathic CPP. The peak LH/FSH ratio found to be lower in obese children, and similar to the girls with CPP, there was an increase in weight-SDS and BMI-SDS of the boys during treatment. It was determined that the height SDS and predicted height at the beginning of the treatment, the father's height SDS and the target height SDS were the factors affecting the final height.